11/01/2012 10:57 am ET Updated Jan 23, 2014

More Vagina Travelogues

I keep learning more eye-opening information about my fellow human beings as I travel around the country talking about Vagina: A New Biography, now in a fifth week on the American Booksellers Association extended nonfiction hardcover bestseller list, and bouncing around the top of the Apple iBooks nonfiction list too. The adventures continue:

Wednesday, Chicago: Lusty Older Women

After a talk in a women's bookstore, a lesbian audience member in her sixties tells me that she was inspired by Vagina to be more romantic with her girlfriend, and acknowledges that some of the little seductions in the relationship had fallen by the wayside, as they can in any relationship. She also said that her gynecologist is startled because she is just as lustful now as she was at any time in her life.

She described many her straight friends' relationships with their husbands as both enter their sixties, and said that most of them say that they are relieved that the sexual aspect of the relationship has died down, along with their husbands' testosterone levels. "The men aren't yelling as much, but they aren't as sexual either," she reports. "The woman says the interaction is like best friends now." She thinks for a minute. "I think I would die if that happened to us" she muses.

This conversation meshes with many conversations I have had on the road with older women, that showcase the incredible variation in female libido in later years. But any stereotypes about sexless older women that our culture offers have definitely been blasted away for me.

Some older women, of all sexualities, are having the best sex of their lives -- including with themselves; others are wondering where their desire went, and have either accepted this or are unhappy about it.

But all of the stories confirm the "use it or lose it" quality of the female sex drive after menopause that the latest science confirms. The more that older women choose to have sex, the data now show, in their post-menopausal years, including solo sex, which turns out to be highly medically beneficial for older women, the more sex they wish to have (including solo sex). But while many doctors who specialize in the sexual health of older women that I encountered in the tour confirm this, only one -- Gail Saltz, M.D., a physician specializing in sexual health who interviewed me for the 92nd Street Y -- added an important caveat that no one else mentioned. Too graphic? To maintain the health and wellbeing of older women's sexual tissues, which can often cause problems post-menopausally, she said that it was helpful for older women to masturbate regularly with some kind of penetration. I conclude that for sure, that recommendation -- as helpful to many and as medically sound as it is -- is not going to make it onto daytime TV.

Thursday, Chicago: Episiotomies and Depression?

I get an email -- one of many similar ones -- from a 58-year-old Midwestern woman telling me that she followed the suggestions in Vagina to find her "sacred spot" (not my language, Tantra's) -- and had "the most intense orgasm of [her] life." Since she had suffered for twenty years from diminished sensation after two vaginal births -- one with an episiotomy (which cuts right through a major sexual center for women, and is standard, though usually unnecessary, in US birth practices) and one with a tear she thought she would never have the intense pleasure she had once had, with her husband of forty years, again.

For those who haven't given birth in America: episiotomy -- cutting the perineum -- is standard practice in the US because the rush to give birth in a for-profit environment means that standard births are sped up with pitocin, which means that a woman likely faces either a tear or an episiotomy -- both of these outcomes can usually be avoided with perineal massage with oil, and time; the massage is considered too sensual a practice for US birthing rooms, and tiem is too costly.

I am getting dozens of reports from readers of Vagina: A New Biography about loss of sexual sensation and sexual happiness following tearing or episiotomy. A major medical secret is that US episiotomies result almost inevitably in a major loss of sexual sensation for women. My emailers are reporting that this affects them and their marriages in very serious ways.

I reported that in Vagina that sexual anticipation of pleasure, and pleasure itself, in women, boosted dopamine, opioids and oxytocin, which go to positive mind-states involving motivation, assertiveness, bliss and a sense of connection and trust. Reading the many emails of women who suffered negative emotional and sexual effects after episiotomy or tearing, I started to wonder if the post-partum depression that affects such a high number of women in America -- between fifteen and twenty per cent of women post partum, according to the Centers for Diseases Control, self-report post-partum depression; PPD support sites such as this one argue that the actual number should be higher. Many studies also show lower satisfaction for women in marriage after the birth of children. Could this data have in some cases something to do with the relative suppression of these positive neurotransmitters and hormones, resulting from tears and from episiotomies that cut perineal neural termini?

This was a question I had explored vis a vis damage from vulvodynia and female genital mutilation; the mass of personal testimony I was receiving, in person and on email, from US women with "ordinary" episiotomies persuaded me that this question was worth more investigation. You can see the damage done to the sexual center in women here -- about a third of women in the US will have to undergo episiotomies in childbirth. Please take a look at Netter Plate 412 in this link -- which shows the innervation [nerves] of the female perineum and pelvis -- to see just how episiotomy or a birth laceration severs one major sexual center for women. And, if you follow the data I offer in the book about dopamine, oxytocin and opioids, this can also mean, trauma there can affect a part of the body that can in turn affect subjective mindstates involving emotion, drive, euphoria, and the sense of attachment and closeness.

I was glad that women with this symptom are finding, from my book, ways to amplify their pleasure again. Any controversy, I feel, was a small price to pay for so many women and couples to regain such an important part of their connection to each other, and for women readers to describe in their own words a renewed connection to themselves.

Friday, Minneapolis: Skanky Webcams

A fun evening talking in the beautiful new Minneapolis city library -- a gorgeous space and great, frank, take-no-prisoners Midwestern questions. (I found that Midwesterners are even more direct, and open to frank discussion about female sexuality, than are their counterparts on both coasts -- in spite of the coasts' self-congratulation about their own sophistication). But in the midst of a great discussion, a homeless man raises his hand: he starts to describe the perverse things you can get women to do on a site called MyFreeWebCam. I have heard a number of stories about the influence of these webcam sites -- the compulsive attraction to some people (so far I have just heard from or about men, but I am sure that the appeal is not gender exclusive) that is involved in a live site in which you can get women to do extremely degrading acts.

A woman I know left her very respectable husband because she found out about what he had gotten hooked on, and she could not integrate that idea of his tastes into her relationship with him. Jokes about watching women urinate on webcam, etc, are finding their way, as I noted elsewhere, into mainstream media such as a Californication episode I saw on a United flight recently. I worry that this becomes the new normal. I talk about how a lot of the people on those sites are trafficked, and that that is, to me, an issue even apart from the issue of the content. A very nice young man I meet later in the week back in New York, who interviews me for the site, points out that a video called "Two Girls and One Cup" is an internet sensation. "My mom saw it," he noted.

This lowering of the bar for what is mainstream sexual imagery influences, my audiences are sure, the behavior of kids, an issue I keep heating about. In Chicago, a guidance counselor for middle schoolers says that the standard way the genders relate sexually now in his school is that older high school boys get much younger -- even middle school -- girls to give them blow jobs in the bathrooms in the Mall. No one goes steady; no one dates. The norm is what they are getting from porn, and, he says, there is a complete vacuum of adults discussing more appropriate or emotionally contextualized sexual behavior with them. So, he notes, how would they know that that is not just "how sex is?"

Monday, New York: "Choking Out"

The testimonies about how porn is influencing behavior are unending. I have a great time chatting with Jane Pratt and her colleague Mandy, a comedienne, on Jane's radio show, but also learned something a bit startling. They are super graphic, and very, very funny. I am very pleased to sign a Vagina book for Courtney Love, a friend of theirs, who has tweeted supportively about the book ("Hole" was quite a band name for the time; -- an homage to the concept of some kind?) But again the influence of more and more violent porn startles me: Mandy says that several of the guys she recently had one-night stands with tried to "choke her out" -- asphyxiate her, with their hands around her neck -- as orgasm approached (I forgot to ask: was this assumed to be for her or for him? Or both?) The women were surprised that I was surprised -- "Choking out" is a porn cliché Jane Pratt explained to me. Mandy also said that someone she had had a one-night stand with had spat on her -- which had led her to find herself in tears on the train on the way back.

I am not surprised that auto-asphyxiation is erotic to some people -- it has had its fans since sex began, and subcultures in Victorian England and modern Japan. I am surprised that someone in a casual one-night-stand would try to do it to a woman without talking to her about it or getting a measure of her interest. I was surprised that it seemed to have become sort of normative. And yes, that escalation worries me -- because of the numbing effect of porn which I discuss in the porn chapter of the book, and because of its result: people need more and more extreme imagery to get the same level of arousal.

In the week ahead I get a stream of emails about porn addiction overtaking marriages: a woman in a Southern state, with five boys, who said she "lost" her husband to his porn addiction and was now trying to figure out how to raise her sons in a different way; a acquaintance, a talented artist in her twenties who emails me that she is now divorced and that my porn chapter led her to realize that her young husband -- also in his twenties -- who had to watch porn at times in order to have sex with her, and who became irritable and hostile if he did not ejaculate multiple times a day, was probably a porn addict -- and that the "unseen" dependency on porn created a toxicity in her marriage that she is only now understanding. It is sad to have such multi-layered confirmation that so many couples who might otherwise be able to make each other happy are torn apart by this issue.

Friday, New York: Alarming T-Shirt?

Breakfast with the very nice young men from -- the editor and a photographer. They bring up the numbing effect of porn themselves, which makes me wonder if this side effect is becoming known among young people, which would be a good thing in my view. We have a great, wide-ranging, delightful and perfectly mutually respectful conversation.

But then, outside, after he has asked me for one more photo op, this time with him, and I agree, the editor takes off his sweater with a flourish, and the photographer starts snapping away. The editor is, I now see, wearing a T-shirt with a woman's long naked legs on it, teetering in high heels. Her legs are spread apart, her hands cover her genitals as if in self-defense, and her panties are pushed halfway down.

Hard to interpret the t-shirt exactly -- but it certainly carries a sense of something being done sexually to the half-seen woman that she does not want.

The image definitely feels like a challenge of some kind. And the moment was staged -- planned in advance.

The poor photographer, a very sweet young man, had seemed oddly uneasy, even guilt-stricken, throughout our breakfast. Now I sort of got the source of his anxiety.

It is a challenge -- but to what, I wonder? Is it about shocking Mom? Some kind of power struggle? Or is this one of those moments where the same image reads very differently to a woman and a man -- could it be just edgy to him, or sort of cool, or simply thematic -- the only vagina-oriented piece of clothing he had lying around?

The photographer encourages me to stand next to the editor and his t-shirt.

What do I -- a free-speech activist -- say: "I won't stand next to your t-shirt? "

With a sigh, I stand next to the editor and his confrontational-to-me, or cool-to-someone, or simply ambiguous t-shirt.

Monday, New York: The Orgasm fMRI in New Jersey

Dr. Barry Komisaruk and Dr. Beverly Whipple, pioneers in the brain imaging of female arousal and orgasm, have graciously invited me to visit their lab at Rutgers University in New Jersey. Female subjects there reach orgasm while readings of their brain activity are recorded and then analyzed.

It is Komisaruk and Whipple who found that different touches at different parts of the female sexual area -- clitoris, labia, walls of vagina, cervix - register in different parts of the brain associated with different mind states, a result that I find fascinating,

I am eager to witness the lab and talk to these scientists who have done such groundbreaking work, and will report back... More travelogues soon!

Warmly, Naomi